Child’s Name__________________________________________________

Age________________________

Address_______________________________________________________________________________________
      
 _______________________________________________________________________________________

Date of Birth __________________________________

Home Phone________________________________            

E-mail__________________________________

Parent/Guardian _______________________________             Cell _____________________

Parent/Guardian _______________________________             Cell_____________________

Where you heard about us___________________________________________________________

Class(es) you are registering in_______________________________________________________

Please list any medical conditions that we should be aware of (allergies etc):


I give my consent for my child or myself to participate in the programs of Siri’s School.  I understand, that with physical activity, there is a risk of injury during participation in class.  I hereby waive and release Siri’s School of the Performing Arts and all emplyees thereof from all claims of liability including accidents or injury while on or about the premises, or while on off-site performances or activities.

                                                                                                     ________________________________                     ______________                                      
Parent Signature                                                                              Date

Registration Fee: $15 per student ______ or $25 per family ________

First Month's Tuition: $__________            

Total: $_____________                

Please make checks payable to Siri’s School, the first month's tuition and registration fee are both due upon registration.  This will reserve your space in class and is non-refundable. 







Registration:

A non-refundable fee of $15 per student/$25 per family and the first months tuition is required yearly at time of registration. This reserves your space in the class and all students must pay it.

Payment or Tuition:

Tuition must be paid the first class of every month, made Payable to Siri’s School. Please drop tuition into payment box provided in lobby. Failure to pay by the 7th of the month will result in a $10 late fee.  All NSF checks will be charged a $30 NSF Fee.  Tuition is the same every month regardless of the number of classes for dance, this includes the months of September, December and June.  Voice is charged by how many lessons in that month. Student accounts must be paid in full by the recital or the student will not be permitted to perform in the recital.

Costume Fee:

Costume fees will be billed in January, and must be paid for by the end of February, in full.  No costumes will be refunded once ordered.

Attendance:

A minimum attendance standard is required.  If a student misses more than 8 classes after January, he/she will not be allowed to participate in the end of year recital (costumes are non-refundable), as this is not fair to other students.  Please arrive on time for class.

Care of Students:

The school is not responsible for providing before and after class care for students. Parents with students under the age of 5 must remain in the school during the classes. Students are not to be left at the school for excessive time periods before or after their classes.

Injuries:

Parents, legal guardians of minors, students and adult students waive the right to any legal action for any injury sustained on school property resulting from normal dance/gymnastic activity or any other conducted by students before, during or after class time, or while on off-site performance or activities.

Withdrawals:

No withdrawals will be accepted after January 31st (because of the recital). To withdraw from class(es) a parent or adult student must:

1:Inform school in person, and
2: Complete and sign a withdrawal form provided by the school.
3: You must give 30 days notice.

Photo Release Consent:

I give permission to Siri’s School of the Performing Arts to photograph or video my child(ren) or myself for promotional/recreational use.

I have read and understand the above policies and procedures and agree to abide by them.


_______________________________________________        ____________________    ______________________________________________
Student Name(please print)                                                           Date                                    Signature of Parent or Adult Student


Print both pages, sign and send along with your payment to:

Siri's School of the Performing Arts
33 Northgate Plaza, Unit 6
Harmony, PA 16037